Provider Demographics
NPI:1124026737
Name:WILLIAMS, CLIFFORD P (DMD)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROCKEFELLER PLZ
Mailing Address - Street 2:SUITE 2229
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10020-2003
Mailing Address - Country:US
Mailing Address - Phone:212-757-7070
Mailing Address - Fax:212-307-6871
Practice Address - Street 1:1 ROCKEFELLER PLZ
Practice Address - Street 2:SUITE 2229
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-2003
Practice Address - Country:US
Practice Address - Phone:212-757-7070
Practice Address - Fax:212-307-6871
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NY0338201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice